In a continuation of the 3 New Things series, this week follows up on the British Psychological Society’s critique of the Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-V), talks about irritable mood in bipolar disorder and expresses my general disdain for people who can’t report about mental health accurately.
As I mentioned, mixed moods are technically considered part of the manic phase of bipolar disorder and thus, by definition, are only a part of bipolar disorder type 1. However, those of us with bipolar type 2 can tell you we mix it up with the best of them.
So, in part II of this series on mixed moods in bipolar disorder, I look at mixed moods in bipolar type II.
Mixed Moods in Bipolar Type IINow that we’ve wandered into Diagnostic and Statistical Manual (DSM)-free territory, definitions on mixed states get a bit looser.
Mixed mood states may be, in fact, the most common way of experiencing bipolar type II. I find most people have a hard time distinctly separating “depression” from “hypomania” from “normal” moods. There is just too much crossover.
Additionally, considering mixed moods to be part of the manic phase of bipolar disorder becomes useless when looking at bipolar II. As an article in Psychiatric Times suggests, there are really two types of mixed moods in bipolar disorder:
Those two mood types better reflect my own experience and I think the clinical experience of other patients and doctors.
As one of the Burble’s commenters mentioned, there seems to be a lack of good information on mixed moods available. After some Googling, I would tend to agree. While mixed mood episodes are pretty common for us bipolar folk, few people seem to be discussing it.
This is the beginning of a four-part series on mixed moods in bipolar disorder:
Sometimes writing for a living drives me bonkers. Basically, I have to be brilliant on-command. And seriously. That’s hard.
It’s a lot of work for me. My brilliance gets tired and bogged down in the bits of my job I don’t like doing.
However, then I’m reminded there are many wonderful things about my job. Specifically, I get to learn new things, every day, all the time. While others work at real jobs I spend all day looking up facts and studies and learning things I didn’t know when I woke up.
I love that stuff.
So, I’m creating a weekly feature by sincerely flattering Jane Friedman and stealing her idea. (Jane writes Three Happy Things about writing once a week. Go check her out.) I’m not sure they will be three happy things, exactly, but I will be sharing three new things about mental health I’ve learned each week.
This will give me a chance to share smaller details that don’t make it into a full blog post, pimp the resources I like and otherwise share my knowledge.
On board? Great!
As loyal readers know over the last couple of weeks I have written quite a few pieces both on the Burble and on Breaking Bipolar on suicide after a person I consider a friend attempted suicide. Luckily he is still with us, and I think the writings on the topic will help others who have been through a suicide attempt and the loved ones of those who have attempted suicide.
I don’t want to say something “good” came out of my friend’s suicide attempt because I think that diminishes his personal experience. But maybe others have been helped. And that is thanks to him. Thanks to his honesty and bravery in speaking about his suicide attempt. I’m honored to know him.
So here are articles for:
As requested, I’m going to provide the details on the custom mood / variables I use in the T2 Mood Tracker. These are just my variables, they certainly don’t have to be yours, but they might be good to glance over.
As I mentioned, the difficult a case you are, and boy am I difficult, the more challenging the patterns can be to find. This is why I’ve included these extra variables. Custom moods / variables include:
OK, you’ve sold me as to why I should track my mood (part 1); so just how do I track my mood?
Obviously, the simplest form of mood tracking is just recording depression and mania on a scale, say, of one-to-ten. You could use a “paper” and “pencil” (look it up on Wikipedia).
You might still notice mood trends but that type of mood tracking is not nearly as helpful as it could be. And the more complicated your case, the more you already know, the more subtle your shifts may be and the less you’ll see using simple methods.
There are far more useful, not to mention easier, options.
Most doctors (mostly psychiatrists) will ask you to track your mood if you have a mood disorder like bipolar disorder or depression. And while most people (psychiatrists and patients) would agree mood tracking is good, most people would also admit to not doing it.
I understand why mood tracking doesn’t get done. It’s like a homework assignment when you’re already working full-time. You just happen to be working full-time at being crazy. Homework tends to get left in the book bag.
However, there are easy, painless, simple ways to track your mood that can offer real benefits. Sixty seconds a day. Promise.
If you’ve been around for the last couple of weeks either at the Burble or at Breaking Bipolar, you know it’s been pretty much all suicide all the time. And there will probably be more to come on suicide as it’s an awfully big topic.
But I do have a question for everyone:
In part one I discussed the details of a study about 100 people who attempted suicide in Florida. Part two outlines the predictive factors for suicide attempts identified in this study and how we can use this information to predict who will attempt suicide.
And perhaps more importantly, how you can prevent a suicide attempt in a loved one.
Some of us in the mental health field have heard the suicide warning signs so often it’s practically tattooed on the back of our skull: suicide note, suicide plan persistent thoughts of suicide, previous suicide attempt and so on.
But if you think you know the warning signs for a suicide attempt you’re probably wrong, at least according to a study out of Florida. For example, fewer than 1-in-10 people leave suicide notes and fewer than one-third of people have persistent thoughts of suicide before their suicide attempt.
As I mentioned, a friend of mine attempted suicide last Friday. His life was saved by his friends, the police and hospital staff. I’m grateful his suicide attempt was not successful.
But one of the oddest things about this scenario is after the suicide attempt he was not hospitalized. The hospital stabilized and released him. Just like that. No psychiatric hold. No psychiatric treatment. Nothing.
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